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Quality Assurance in diagnostic radiology: an irreverent view of a sacred cow: annual oration in honor of Albert Soiland, M.D.

The problem of federal regulation of radiologic practice is examined via an in-depth analysis of the Proposed Recommendations for Diagnostic Radiology Facility Quality Assurance Programs as published in the Federal Register by the Commissioner of Food and Drugs. It is shown that the need for such recommendations is not established, that the program proposed by the Commissioner is potentially burdensome for the radiologist, that it does not address the most significant causes of unnecessary patient irradiation, and that the benefits expected to derive from it are, in fact, negligible. This is not to denigrate the value of well-conceived quality assurance efforts, and measures are suggested that might more reasonably be expected to reduce the radiation exposure of the public. The radiologist is urged to 1) conduct his practice in as faultless a manner as possible; and 2) exercise his right to respond to proposals of the federal regulatory agencies.

Cost-Benefit Analysis

Secure bioinformatics: privacy-preserving federated analytics using homomorphic encryption.

MOTIVATION: Large-scale bioinformatics analyses increasingly require collaboration across multiple cohorts and institutions, yet existing workflows often rely on data co-localization, which is slow, difficult to scale, and raises privacy concerns. We present a privacy-preserving federated analytics framework that enables secure statistical analysis across distributed datasets without transferring raw data, by performing all computations on encrypted data via cryptographic methods. RESULTS: We evaluate the framework by validating polygenic risk scores and conducting meta-analyses on two real-world cohorts. The proposed solution achieves over 99.9% accuracy relative to plaintext analyses, while maintaining scalable runtime performance with increasing data size and number of participating sites. These results demonstrate the feasibility of secure federated analytics for practical bioinformatics applications involving sensitive data.

Computational Biology

PLK1/FOXM1-associated tumor-cell state and macrophage-related immune features in endometrial cancer.

BACKGROUND: Polo-like kinase 1 (PLK1) and forkhead box M1 (FOXM1) have been widely studied in various cancers; however, their expression characteristics in endometrial cancer (EC) and their potential association with tumor microenvironment remodeling remain insufficiently characterized. METHODS: This study integrated The Cancer Genome Atlas uterine corpus endometrial carcinoma cohort, Gene Expression Omnibus, pan-cancer transcriptomic data, Human Protein Atlas/Clinical Proteomic Tumor Analysis Consortium, and local immunohistochemistry data to evaluate PLK1 expression and clinicopathological relevance across transcriptomic, proteomic, and histopathological data. Differential expression, survival, gene-set enrichment, transcription-factor enrichment, and immune-infiltration analyses characterized PLK1-associated features. In vitro experiments combined EC cell lines AN3CA and HEC-1A with co-immunoprecipitation, Western blotting, Transwell assays, and a THP-1 conditioned-medium model. Drug-response prediction and structure-based analysis prioritized candidate therapeutic hypotheses. RESULTS: PLK1 was consistently upregulated at both mRNA and protein levels in EC and was associated with higher tumor grade and International Federation of Gynecology and Obstetrics (FIGO) stage. In survival analysis, higher PLK1 expression was associated with poorer overall survival in univariable models but not after adjustment for age, tumor grade, and FIGO stage. Functional enrichment analysis showed that PLK1-associated genes were mainly involved in cell-cycle and mitotic processes. FOXM1 was identified as a potential candidate component of the PLK1-associated transcriptional program and was positively correlated with PLK1 expression and cell-cycle-related features. In vitro experiments supported an interaction between PLK1 and FOXM1 and suggested that FOXM1 Thr600 phosphorylation-related alterations were associated with migration and invasion phenotypes. Furthermore, the PLK1/FOXM1-associated tumor-cell state was linked to macrophage-related immune features and changes in the M2-like marker profile of THP-1-derived macrophage-like cells. Drug response analyses suggested differential predicted sensitivity patterns in PLK1-high tumors, providing candidate therapeutic hypotheses for further validation. CONCLUSION: The PLK1/FOXM1-associated tumor-cell state may represent a distinct molecular feature associated with proliferative activity, invasive phenotypes, and macrophage-related immune features in EC. This study provides preliminary evidence supporting the biological relevance of this molecular feature and highlights potential therapeutic directions for future investigation.

FoxM1

Change in the mental health field?

An analysis of the current roles of the federally funded community mental health center and the public mental hospital suggests that despite the rhetoric about a community mental health revolution, the mental field has yet to undergo significant change. Ideological, political, economic, and structural barriers-characteristics of the field itself-impede such change outside, inside, and across the centers and hospitals. Recent court decisions on patients' rights, however, have the potential for moving the field into a period where "bold new action" actually can occur.

Attitude of Health Personnel

[Epidemiology and prevention of major cardiovascular diseases].

Analysis of the situation in the Russian Federation indicates that despite a small downward tendency, cardiovascular diseases (CVD) remain a leading cause of death among the population. Epidemiology studies of major CVD risk factors detected their high prevalence in several cities of the Republic despite noticeable geographic differences. The claim that prevention of CVD should be started from childhood remains still declarative and needs further large comprehensive studies. The accomplished research prevention programmes turned out to be feasible at community level and allowed one to develop organizational forms of their realization. To bring these projects into everyday life is a challenge as it involves many social problems.

Cardiovascular Diseases

Non-typhosa Salmonella species: analysis of 94 isolations.

Despite rigorous control measures by local, state, and federal health agencies, salmonellosis continues to be one of America's most troublesome epidemiological problems. Salmonellosis, a reportable disease, is estimated to infect more than two million persons each year. However, only 10 to 12 percent of cases are actually reported. To study the impact of salmonellosis at Howard University Hospital, the authors made a statistical analysis of non-typhosa Salmonella isolated during a two-year period. The study emphasizes the epidemiological aspects of, and useful isolation and identification techniques for, non-typhosa Salmonella.

Black People

Independence of VNTR alleles defined as fixed bins.

An analysis is presented of data collected by the Federal Bureau of Investigation at six unlinked variable number of tandem repeats (VNTR) loci for the United States population. Databases have been constructed of VNTR profiles of Caucasians, Blacks and Hispanics from Florida, Texas and California. There was very little evidence for correlations between lengths for pairs of VNTR fragments, within or between loci. When the fragment lengths were amalgamated into discrete bins, there was also little evidence for disequilibrium over all genotypes, within or between loci, for the Caucasian database, although some disequilibrium was found for the Black and Hispanic databases. No disequilibrium was found for the Caucasian or Black databases when tests were confined to heterozygous individuals. In cases of global disequilibrium, local tests can be applied to specific genotypes. The results suggest that, at the bin level, frequencies of VNTR profiles can generally be estimated as the products of the frequencies of the constituent elements. This overcomes the problem of estimating population frequencies when any particular profile does not exist in the database. There is some evidence for different frequencies, at the individual bin level, between geographic samples within each of the Caucasian, Black and Hispanic databases, and considerable evidence for differences between the three databases. These differences are less evident for the frequencies of four-locus profiles.

Alleles

Cooperative state-federal turkey ornithosis task force, Texas, 1974.

Ornithosis was suggested by a routine analysis of tissue specimens from Texas turkey flocks submitted to the Texas A&M University Poultry Disease Laboratory at Gonzales on April 30, 1974, and of subsequent specimens from four additional flocks. Subsequently, illness in humans at turkey processing plants in Texas, Nebraska, and Missouri, implicating turkeys from Texas, was confirmed as ornithosis in July 1974; and, associated with this outbreak, ornithosis was suspected as the cause of the death of one human. Action was taken by state and federal poultry disease control and inspection officials, public health agencies, and the turkey industry in Texas.

Animals

Targeted ORF8-N Sanger Sequencing as a SARS-CoV-2 Surveillance Contingency During Supply Shortages.

BACKGROUND: Global shortages of next-generation sequencing (NGS) reagents threatened SARS-CoV-2 genomic surveillance in low- and middle-income countries during the COVID-19 pandemic. METHODS: During the 2021 NGS reagent shortages, we implemented targeted ORF8-N Sanger sequencing for SARS-CoV-2 variant surveillance in Brazilian public health laboratories. RESULTS: In silico analysis of whole-genome sequencing (WGS)-derived SARS-CoV-2 genomes from the Federal District, Brazil, showed that the ORF8-N target discriminated the major 2021 lineages (Gamma and Delta) and enabled analysis of ˃300 samples despite constrained NGS access. CONCLUSIONS: Targeted ORF8-N Sanger sequencing was a useful temporary contingency during NGS reagent shortages but offered lower phylogenetic resolution than WGS.

SARS-CoV-2

National health insurance policy in the United States: a case of non-decision-making.

Despite the vast range of commentaries and research on the current health care crisis, little research attention has been focused specifically on the lack of federal response to this crisis. As a way of focusing analysis on the specifics of Congressional inaction, it is suggested that both the range of health care proposals and the current debates in Congress may be seen as part of an ongoing bargaining process over legitimate alternatives for modication of health care delivery. It is argued that the lack of any new health care legislation may be seen as the result of a series of non-decision by conservative Congressional representatives of the dominant medical interest groups. These non-decisions have successfully excluded any challenges to those interests by reliance upon a predominant "mobilization of bias" to effectively define and/or divert these challenges as illegitimate attempts at change. The changes which eventually evolve from Congressional compromise may represent a modification of the prevailing bias concerning legitimate alternatives, but are unlikely to modify the relation of the controlling interests involved.

American Medical Association

Variables associated with the winter camping location of elderly recreational vehical owners in southwestern Arizona.

During the winter of 1973-1974, 580 elderly recreational vehicle campers were interviewed in six private trailer parks and four public camping areas in southwestern Arizona and Southern California. The ten sites represented four different types of camping environment: (1) highly developed, relatively expensive urban private trailer parks, (2) moderately developed, relatively inexpensive, rural private trailer parks, (3) authorized, developed, free federal campgrounds, and (4) unauthorized, undeveloped, free public land camping areas. Analysis of variance was utilized to identify those respondent characteristics most strongly associated with the type of site selected for winter residence. The most important of these variables were per person annual income, woman's age, man's education, woman's total preretirement adult camping experience, value of mobile quarters and tow vehicle, and percentage of the year lived in a recreational vehicle. Several financial indicators and certain noneconomic characteristics of females were strongly associated with winter camping location.

Age Factors